10-0134 (BLCK)P.O. BOX 1504 ^' VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 2/23/10
Application Number:10�-00000134-_�� Owner:
Property Address: 55421 RIVIERA HAGUE RESIDENCE ....�_
APN: 775-153-003- - - 55421 RIVIERA �
Application description: WALL/FENCE LA QUINTA, CA 92253 0d
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: 575 FEB n
_ •. --- --.� __ ___._. _.'. - _Contractor. _ ---
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Applicant: 7 Architect or Engineer: AZURE POOLS AND SPAS
P.O. BOX 10641 �~'—,..__.�._-_•_i; r:r'�+rr
lJ PALM DESERT, CA 92255 "'---•
(760)322-7665
Lic. No.: 802919
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Sectio 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
Lice �CI�%s C53 License No.:.802919
Dai ?� �C`ontractor: "
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
Permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
1 _) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.). - -
1_) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
hereby affirm under penalty of perjury one of the following declarations:
have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
_ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier DELOS INS CO Policy Number 02DKRM12002794
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person. in any manner. so as to become subject to the workers' compensation laws of California,
and agee that, if I shout become subject to the workers' compensation provisions of Section
�U
3200 of the Labor Cod pet mply with those provisions.
�--�
—D Applicant:-
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. I agree, to comply with all
city and aunty iFnces and state laws relating to buil ng onstruction, and hereby authorize representatives
of t7 pt upon the above-mentioned propi: - f spec ' p oses.
�.
•Date Signature (Applicanto Ar genu:
Application Number . . . . . 10-00000134
Permit WALL/FENCE PERMIT
Additional desc .
Permit Fee 17.00 Plan Check Fee
.00
Issue Date . . . . Valuation . .
575
Expiration Date 8/22/10
Qty Unit Charge .Per.
Extension
BASE FEE
15.00
1..00 2.0000 HND BLDG 501-2,000
2.00
------------------------
Special Notes and Comments
23 LN FT X 5' 6" (6) GARDEN BLOCK WALL
TO CITY STANDARDS & APPROVED "PLANS
----------------------------------------------------------------------------
Other Fees .. . . . .. . . . . BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
=---------
Due
---------------------------------------------
Permit Fee Total 17.00 .00 .00
17.00
Plan Check Total .00 .00 .00
.00
Other Fee Total. 1.00 .00 .00
1.00
Grand Total 18.00 .00 ..00
18.00
LQPERMIT - .
Bin #
City of La Quinta
Building a Safety Msion .
P.O. Box 1504, 78-495 Calle Tampko 4
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
'
Permit #
^1 J
Project Address:
' 1/l
Owner's Name'
n
a. .� S-
i Al
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: 1 S
Address: U f I D LAI
S
Telephone:
Project Description: I (�
City, ST, Zip:
Telephone:
State Lic. # : qb'JA J e J City Lie. C
Arch., Fngr•. Designer.
'
Ad&=:
City, ST. Zip:
Telephone:
State Lie. #:
Name of Contact Person:
Construction Type: Ocaapancy:
Project type (circle one): Naw Ad -9'n Alter Repair Demo
Sq. Ft.: # Stories: # Units:
Telephone # of Contact Person: 2
Z Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Plan Sets
Req•d
Rec'rl
TRACKING PERMIT FEES
Plan Check submitted Item Amount
Structural Cain.
Reviewed, ready for corrections Plan Check Deposit
Truss Cala.
Called Contact Person Plan Cbsdc Balance
Mdc 24 Cala.
Plana picked ■p Coostrction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
21' Review, ready for correctioneusue Electrical
Subcoatactor List
Called Contact Person Piumbiag
Grant Deed
Plans picked up S.M.L
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
''' Review, ready for correctionuPusue Develooer Impact Fee
Planning Approval
Called Contact Person A.LP.E-
Pub. Wks. Appr
Date of permit Issue
School Fees
Total ?ermit Fees
Azure Pools & Spas, Inc.
_ P.O. Box 10641 ..
SPA+18" )ERWATER BEINCH - Palm Desert, CA 92255.'.
CONCRETE CAP RBB +12"
WITH STAIR WITH 4' CASCADE
r SPILLWAY
Of
�• fir; „i.� f'1 'f; s - . •
-3 6' y , , y� - . R REPIT +12" WITH LIGHT BROOM
FINISH CAP/TILE FACE.
�.. v SRATWAT.T.. AT 4-1 R" WITH
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